1104779420 NPI number — WITHIN THESE WALLS PROFESSIONAL COUNSELING CENTER PLLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104779420 NPI number — WITHIN THESE WALLS PROFESSIONAL COUNSELING CENTER PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WITHIN THESE WALLS PROFESSIONAL COUNSELING CENTER PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1104779420
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/17/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5315B CYPRESS CREEK PKWY STE 366
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77069-4403
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
832-850-6422
Provider Business Mailing Address Fax Number:
832-850-7852

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
27103 BAHIA GROVE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KATY
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77493-5271
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
832-850-6422
Provider Business Practice Location Address Fax Number:
832-850-7852
Provider Enumeration Date:
02/17/2026

Additional Information

Authorized Official

Authorized Official Last Name:
WASHINGTON
Authorized Official First Name:
NAKEISHA
Authorized Official Middle Name:
QUIAN
Authorized Official Title or Position:
THERAPIST-OWNER/MANAGING MEMBER
Authorized Official Telephone Number:
832-503-1576

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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